At a large tertiary level hospital in South Africa, patients were in the past expected to contribute to the costs of their care by paying means-tested fees- per visit to an outpatient clinic, or per day in case of a hospitalisation. Fees started at R160 per visit for the lowest income tier. Patients were exempted from the payment if they could prove that they don't have a regular income. In practice, patients in the lowest income tier were accepted into the clinic for their first 3 visits, but had to bring proof of no income at their fourth visit at the latest. During the first year of the ART clinic's operation, this proof of income (or the absence of it) could have been a handwritten affidavit stamped at their local police station. During the second year, however, this policy was changed and patients had to supply a print-out from the employment registry at the Department of Labour. This lead to the clinic seeing an increase in the number of patients defaulting from treatment after their third visit. Patients were ?complaining that the new procedure meant that they had to travel to the city centre and queue for a day at the Department, or sometimes for several consecutive days, in order to obtain the necessary documentation. In October 2006, hospital fees were abolished completely for patients accessing the ART clinic, but patients were still expected to settle their outstanding fees for the period before this general exemption took hold. 

Question 1: What would you say about the fee policy at this hospital?